| NPI | 1750762043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J PORTONOVA Owner 570-387-2202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006404) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2021-09-17 |